Bleaching and skin-lightening practice among female students in South India: A cross-sectional survey

Bleaching with skin-lightening preparations is a common practice in our society. Particularly, a practice simply known as "bleaching"-referring to application of skin-lightening chemicals including ammonia, hydrogen peroxide, and hypochlorite, repeated at intervals, as a salon-based or home-based procedure appears wide-spread among young females in India. However, there is limited medical literature on "bleaching."

We aimed to estimate the prevalence of "bleaching" among female students of our campus and to assess the knowledge, attitude, and practices regarding "bleaching" in the same population.

A cross-sectional, questionnaire-based survey was conducted among the female students of the campus following a presurvey focus group discussion with a representative group. A pilot survey conducted to standardize the survey questionnaire showed a high reliability (Cronbach's alpha > 0.7). Descriptive statistical methods were used to assess survey results, and frequencies were presented as percentages.

A total of 880 valid responses were analyzed (age group 17-30 years, mean age-20.24 years). 34.77% had done "bleaching" at least once. 63.8% of respondents did not know the ingredients, and 40.5% did not know about the side effects of "bleaching." 60.06% of those who bleached had experienced an adverse effect. 58.18% respondents knew about "bleaching" from friends/relatives and 17% from parlors. Only 2.3% respondents had consulted a dermatologist, and only 22.8% had used sunscreens. Top motivation to bleach was to lighten facial hairs (19.5%), for a "lighter" complexion (15.1%) and achieve "glow" before a function (15.2%).

Facial skin and hair "bleaching" is common in our society, and awareness regarding "bleaching" is low even among educated youth.